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Today's Practice | Sep 2016

How Improving Your Fitness Can Make You a Better Surgeon

Movement is key; even a brief walk can be helpful.

As a physician, you have dedicated your life to helping others get and stay healthy. But how much time do you dedicate to your own health and fitness? Are you aware that better fitness can improve your skills as a surgeon?


• Moving your body more and deepening your mindbody connection can help to maximize your potential as a surgeon.

• Hand dexterity can improve with exercise.

• Instead of worrying about the amount, type, and intensity of exercises you do, focus on moving more.

It is well documented that exercise improves a wide array of health markers, from blood pressure to cholesterol, and that it may prevent numerous chronic illnesses including heart disease and certain cancers. You probably know this already. But did you know some studies suggest that your hand dexterity can improve with exercise?1 Age can have a negative effect on hand strength,2 but one study suggested that maintaining hand strength as you age can help you retain better hand dexterity.3 Another demonstrated significant reduction in hand dexterity error among people who performed yoga breathing exercises.4

It is not only your body that reaps rewards from exercise, but also your brain. Recent research suggests that regular moderate-intensity exercise stimulates brain regions involved in memory function to release a chemical called brain-derived neurotrophic factor (BDNF).5 BDNF rewires memory circuits so that they work more effectively.

In a popular TED Talk, British neuroscientist Daniel Wolpert, FMedSci, FRS, stated that the reason our brains evolved was not to think or to feel but to control movement.6 Movement is the central theme that underpins physical health and exercise. When we move, we blend the three pillars of fitness—strength, cardiovascular health, and flexibility—into one. Some movement activities use more of one component than the others, but all three are necessary to create movement.


So how much should we move? What kinds of exercises should we do? The amount, type, and intensity of exercises one should do are hotly debated topics. Some organizations recommend light daily exercise that gets the heart pumping, such as brisk walking, swimming, and yard work. The American College of Sports Medicine recommends resistance training two to three times per week, flexibility exercises two to three times per week, and 150 minutes of moderate-intensity exercise per week or vigorous intensity exercise three times per week for 20 minutes.7,8

As a strength and conditioning specialist, my advice is not to worry so much about these details, but instead to move more rather than less. Walking, hiking, swimming, running, playing sports, lifting weights, and doing yoga, among other activities, are all beneficial. Worrying about whether one is more effective than another misses the point, which is to move more and to stay active. You can go for a brisk walk nearly any time and anywhere. You do not need fancy equipment, and you can squeeze a walk in even if you have only 10 minutes.

That being said, it is possible to structure a workout so that you get flexibility, cardiovascular, and strength benefits efficiently in just 15 minutes. You can do this by combining full-body strength exercises into circuits and using properly structured warm-up and cool-down routines. Just two or three full-body workouts per week can make a huge difference in your life.


The following workout (picture depictions on the following page) requires just your body weight, which means you can do it anywhere, including at the office, while traveling, or at home.

Warm-up. A warm-up helps improve mobility, can decrease risk of injury, and primes the body for an effective workout. As a sample warm-up, complete one set each of the following:

• 10 leg kicks (each leg)

• 10 spider crawls with rotation (alternating)

• 20 jumping jacks

Strength circuit. Complete the following circuit of five exercises for three rounds, with minimal rest (less than 30 seconds) between exercises:

• 10 bodyweight squats

• 16 forward lunges (alternating)

• 10 pushups

• 16 side lunges

• 25 jumping jacks

Cool-down. Light stretching at the end of your workout can promote gains in flexibility. Complete one set of each exercise for 30 seconds:

• Seated hamstring stretch (each side)

• Half-kneeling hip flexor stretch (each side)

• Child’s pose

To make this workout more challenging, add a weighted vest or rest for less time between sets. To make it easier, choose easier variations of each exercise (ie, assisted squats or pushups on an elevated surface) and rest for more time between sets.


Your body is built to move. One way that you can help maximize your potential as a surgeon is by moving more and deepening your mind-body connection.

Please consult with your general practitioner before starting an exercise routine. n

1. Ranganathan VK, Siemionow V, Sahgal V, Liu JZ, Yue GH. Skilled finger movement exercise improves hand function. J Gerontol A Biol Sci Med Sci. 2001;56(8):M518-522.

2. Ranganathan VK, Siemionow V, Sahgal V, Yue GH. Effects of aging on hand function. J Am Geriatr Soc. 2001;49(11):1478-1484.

3. Martin JA, Ramsay J, Hughes C, Peters DM, Edwards MG. Age and grip strength predict hand dexterity in adults. PLoS One. 2015;10(2):e0117598.

4. Get your heart pumping in the fight against forgetfulness. Harvard Health Publications, 2013. http://www.health.harvard.edu/mind-and-mood/get-your-heart-pumping-in-the-fight-against-forgetfulness. Accessed July 29, 2016.

5. Telles S, Singh N, Balkrishna A. Finger dexterity and visual discrimination following two yoga breathing practices. Int J Yoga. 2012;5(1):37-41.

6. Wolpert D. The real reason for brains. TED Global 2011. https://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains?language=en. Accessed July 29, 2016.

7. ACSM issues new recommendations on quantity and quality of exercise [press release]. American College of Sports Medicine, 2011. http://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-recommendations-on-quantity-and-quality-of-exercise. Accessed July 29, 2016.

8. Garber CE, Blissmer B, Deschenes MR, et al; American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334-1359.

Marc Perry, CSCS, CPT
• Founder and Chief Executive Officer, BuiltLean
• mperry@builtlean.com